This case involves an 11-year-old girl with a history of psychiatric and behavioral disorders. She came from an abusive home and was placed in the foster care system. While living with a foster family, she was sexually abused by one of the older foster children in the house. She was eventually removed from the house but acted out violently in subsequent homes. She was brought for psychiatric evaluation and admitted to a facility. After 2 weeks of admission, the attending psychiatrist wrote that the child was ready for release. In spite of this report, Child Protective Services made no arrangements to have the child removed. The child was left in the facility for 9 weeks with no word as to her next placement. At week 9, she was sexually abused by another patient. A psychiatrist was sought to opine on the hospital’s liability for not protecting the patient from harm and to discuss whether or not the physician should have facilitated the child’s discharge.
Question(s) For Expert Witness
- 1. Please describe your background as a psychiatrist.
- 2. Do you treat routinely treat patients like the one described in the case?
- 3. Have you ever lectured or published on the psychiatric effects of child abuse?
Expert Witness Response E-001060
I have a lifetime board certification in child psychiatry. Over the past 30 years, I estimate that I have seen 18,000+ kids. I have been doing mostly outpatient work with children since about 2004, and I have had many cases like this. I have given talks at national conventions for social workers and conferences on child abuse. I present on cases of children who have been abused and how the abuse leads to the development of personality disorders, such as antisocial and borderline personality disorder. These disorders stem from abuse and neglect these children suffer at a young age. As a result of their trauma, these kids go on to develop reactive attachment disorder of childhood. I think his case has merit based on what I know so far. It can be extremely difficult to find dispositions for kids like this, and there are often not enough appropriate placements available. Regardless, the facility, lead by the psychiatrist as captain of the ship, has the absolute responsibility to keep all patients safe and free from abuse and neglect while under their care. In that way, this case speaks for itself.